Provider Demographics
NPI:1568647667
Name:WORTHY, KENDRA C (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KENDRA
Middle Name:C
Last Name:WORTHY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10903 NEW HAMPSHIRE AVENUE
Mailing Address - Street 2:MAIL STOP 4447
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20993-0002
Mailing Address - Country:US
Mailing Address - Phone:301-796-0561
Mailing Address - Fax:301-796-9836
Practice Address - Street 1:10903 NEW HAMPSHIRE AVENUE
Practice Address - Street 2:MAIL STOP 4447
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20993-0002
Practice Address - Country:US
Practice Address - Phone:301-796-0561
Practice Address - Fax:301-796-9836
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist